| NPI | 1831483866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 281781) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02273) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2017-01-20 |